Australia: Call for script-free Tamiflu drug sales

[Shiloh]

Source: http://news.smh.com.au/call-for-scriptfree-tamiflu-drug-sales/20080428-2917.html

Call for script-free Tamiflu drug sales

April 28, 2008 - 3:12PM

A new push is underway to have the drug Tamiflu made available without a prescription to limit the deadly effects of influenza this winter.

A submission received by the National Drugs and Poisons Scheduling Committee has called for change in the classification of Tamiflu so it can be bought over the counter in pharmacies.

Currently, the antiviral drug is scheduled S4. Many specialists argue its prescription-only status prevents sick people from getting the drug quickly enough to be effective.

Pharmaceutical company Roche, which markets the drug, said it was not behind the submission but it would welcome "any improvement of access to Tamiflu for all Australians".

Dr Ian Barr, deputy director of the World Health Organisation (WHO) Collaborating Centre for Reference and Research on Influenza in Melbourne, backed rescheduling of the drug to make it more accessible to the public.

Anecdotal evidence from New Zealand suggested Tamiflu sales increased four-fold when the drug was taken off prescription last winter, he said.

"It would also increase the market for these drugs, so that the manufacturers will continue to market them for when we might really need them in an emerging pandemic," Dr Barr said.

Pharmacy Guild president Kos Sclavos said the guild had not yet made a submission but it expected to support the move.

"Last winter, there was concern because no one could get into a GP quickly enough ... so making it easier to get, with the proper protocols, is a positive."

Retired Australian biochemist Graeme Laver, who helped develop Tamiflu and its sister drug Relenza, told AAP he too would lobby the government again to reschedule the drug.

"I've been pushing the minister on this for a while, but we see that (federal Health Minister) Nicola Roxon is more likely to give it the thumbs up than the previous government," Professor Laver said.

The 2007 flu season was the most severe since 2003.

Six children died in Western Australia, Victoria and Queensland from the two widely circulating virulent strains of influenza A, H3N2 and H1N1.

Virologists say there are early signs the deadly epidemic will not be repeated this year.

? 2008 AAP

 

[tropical]

Re: Australia: Call for script-free Tamiflu drug sales

"Pharmacy Guild president Kos Sclavos said the guild had not yet made a submission but it expected to support the move.

"Last winter, there was concern because no one could get into a GP quickly enough ... so making it easier to get, with the proper protocols, is a positive."

Retired Australian biochemist Graeme Laver, who helped develop Tamiflu and its sister drug Relenza, told AAP he too would lobby the government again to reschedule the drug."

:applause:

 

[Giuseppe]

Re: Australia: Call for script-free Tamiflu drug sales

A pharmacy off-the-count distribution of antimicrobial agents should be prohibited.
1.st: last week WHO update about A/H1N1 seasonal human influenza virus isolates resistant to oseltamivir reports 23% incidence among new isolates (+/- 180);
2.nd: adverse psychiatric events related to use of NA inhibitors in children and adolescents need special attention;
3.rd: antibiotics misuse experiences should be well in mind and the handful of antiviral agents in the pocket need to be keep out of marketing considerations.
Not!, antivirals as OTC 'best-sellers' is pure madness.

 

[gsgs]

Re: Australia: Call for script-free Tamiflu drug sales

everyone decides by him/herself what to buy and take.
Just make sure that they are well informed about the risks.
(IMO)

 

[tropical]

Re: Australia: Call for script-free Tamiflu drug sales

You are correct gsgs,

and I must added that:
"A pharmacy off-the-count distribution of antimicrobial agents should NOT be prohibited."
because that's the only way the mass population can got an little chance in an pandemic event beside the "would be distributed" - but shure it would be NOT in time (<24-48h by a GP).

There will be no vaccine available than for the "critical" workers (gov/mil/pol/health/fire/garb - ~10% of population (?)), and probably no Tamiflu (only for the same folks, and for the initial blanketing).

We can see that policy scheduled now in Japan (FT threads posts), the others leave it for the last moment to divulgate it.

What would do the others, the "ordinary" citizens - they will only pray, or try to buy fake vacc./Tamiflu on skyrocketing prices.

Are they paying the taxes- yes, than they must have the righ to buy an registered medicine, antiviral, and other meds.

If a country stocked up pre-pandemic vaccines, and antivirals for ALL citizens, we can already be unsure if that med/vac would arrive to the final recipient in an pandemic midst.

We can't do that distribution effort in an higly developed nation now, and for an ordinary flu season:
"Last winter, there was concern because no one could get into a GP quickly enough ... so making it easier to get, with the proper protocols, is a positive."

It's comprehensive the wory about the resistance to oseltamivir, but those meds will nobody using if it's not strictly necessary - a pandemic, or a critical life condition by seasonal flu in a chronical patient.

If that's will be a problem, than oseltamivir is not an real option for pandemics - we cannot preserve it working in a way that it's on standby only for 1% of the world population.

Nobody sane will take antivirals unnecessary.

If we deny this free market possibility we divide in future the population to "enaugh important (critical workers) to treat/live", and "un-important (die, if triaged without enaugh life chances, or meds at hand"), and all this will be possible because of "triage policies" which don't want to press a country to put in time enough money to buy pre-pandemic vaccs, and antivirals/other meds, for ALL of the population.

 

[Sally Furniss]

Re: Australia: Call for script-free Tamiflu drug sales

New Zealand Tamiflu thread http://www.flutrackers.com/forum/showthread.php?t=39296

 

[Giuseppe]

Re: Australia: Call for script-free Tamiflu drug sales

You are correct gsgs,

and I must added that:
"A pharmacy off-the-count distribution of antimicrobial agents should NOT be prohibited."
because that's the only way the mass population can got an little chance in an pandemic event beside the "would be distributed" - but shure it would be NOT in time (<24-48h by a GP).

Please note that the piece of news refers to seasonal human influenza and not to a pandemic scenario. It is absolutely a bad idea to adminster antivirals or antimicrobial agents without medical supervision and it is the best way to enhance viral resistance and antibiotic-resistant superinfections spread.
If people intend to stockpile a certain amount of drugs, only medical personnel should prescibe it and deliver precise advice about possible use, conservation, storage, and disposal after expiration.

 

[gsgs]

Re: Australia: Call for script-free Tamiflu drug sales

there could be vaccine available in some countries.
I don't know for Italy.

No medical supervision needed, when we have internet !
Enhance resistant spread ? I've read that the more Tamiflu you take, the more
likely the virus is killed and don't spread.
It could be a problem for immunodeficiant people.
Of course, it's always a good idea to avoid spread in a severe pandemic, resistant or not.

> If people intend to stockpile a certain amount of drugs, only medical personnel
> should prescibe it and deliver precise advice about possible use, conservation,
> storage, and disposal after expiration.

here we disagree. The medical personnel should decide, who gets the drugs and who not
for panflu-stockpiling ?

we discussed this earlier. See e.g. :
http://www.psandman.com/col/tamiflu.htm

 

[tropical]

Re: Australia: Call for script-free Tamiflu drug sales

"here we disagree. The medical personnel should decide, who gets the drugs and who not for panflu-stockpiling ?"

Correct gsgs, IMHO, surely not, otherwise it would be an triage who will remain alive.

Ironorehopper, your statement can be good in normal times, but in pre-pandemic, or pandemic, no way.

Imagin there were only antibiotics for 1-10% of world population, would you rely on that the remaining 90% would got it when 30-50% start catching pneumonia, or it will be preferable that they had buyed it previously (just in case)?
I hope we will not go back to the early days of the Flem. invention, when the newly founded natural antibiotic was (because of it's rarety) a prerogative of an esigue minority ...

Like gsgs correctly said, we disagree on the point where "somebody" - this time the GP (with thousends of patients under) - deciding who will got it, when it's obvious that in an real pandemic event:
- the best policy is remain at home, not spread the illness by going to GP
- the GP can't process enaugh patients in 24 hours to achieve they receive the antiviral in time - if they have stocked it there - thing that is doubtfull, especialy in less-funded communities
- if the med is not at the GP, sure there were no way to catch it at the pharmacies in the above timeline
- finaly the above way of going to the GP is absolutely contrary to an efficient policy of social distancing, and bio-containment.

Only than, if an country is able to organize, distribute antiviral quantities for all, and set up now (not than/if/when pandemic) distributed spot city sites with medical personnel, and rapid tests stocked, ready to detect if the patient have the pandemic flu, or not, than we can wait their's placet, maybe.

 

[Giuseppe]

Re: Australia: Call for script-free Tamiflu drug sales

"here we disagree. The medical personnel should decide, who gets the drugs and who not for panflu-stockpiling ?"

I repeat: last week seasonal human influenza A/H1N1 resistant isolates account by WHO reports among newest isolates 23% of resistant viruses.

The newswires that sparks this discussion appeares every year and there is also the ''creator'' of NA-drugs molecules' citations.

I think this is a bit disappointing.

I am sure that the objective of an intelligent forum as FT is, doesn't meet bad information or marketing policy by pharma corporations with loss of revenue in recent weeks.

Resistance is a nightmare for policymaker and health emergency planners. A useless drug doesn't help solely by storing it into a toilet SoS-Box.

 

[tropical]

Re: Australia: Call for script-free Tamiflu drug sales

"A useless drug doesn't help solely by storing it into a toilet SoS-Box."

Indeed Ironorehopper, if the drug is useless, that's correct.

But even than, summing how much money we thrown on other useless things during our life ...

The problem is that the WHO/... did not released an statement saying that Tamiflu is useless.
At the contrary, they stated that it's the only usefull (for now) antiviral, and we can saw at FT posts that the reasons of the resistance of the flu virus isolates is unknown, or even that they are not related with Tamiflu consumption for seasonal flu.

In such data environment, when the countries still optated for oseltamivir stocks, seems that the drug is not enaugh useless for now.

Maybe that's not the case - and than the situation is worst, what remained than to the population without safe and matched vaccines, and without ventilators, and antivirals - a prayer only?

I'm not advocate any corpy, or vacc/med trial, and I'm sure that nobody liked ingesting harmfull drugs, but what are the options - to be triaged?<!-- / message --><!-- sig -->

 

[Giuseppe]

Re: Australia: Call for script-free Tamiflu drug sales

"A useless drug doesn't help solely by storing it into a toilet SoS-Box."

Indeed Ironorehopper, if the drug is useless, that's correct.

But even than, summing how much money we thrown on other useless things during our life ...

The problem is that the WHO/... did not released an statement saying that Tamiflu is useless.
At the contrary, they stated that it's the only usefull (for now) antiviral, and we can saw at FT posts that the reasons of the resistance of the flu virus isolates is unknown, or even that they are not related with Tamiflu consumption for seasonal flu.

In such data environment, when the countries still optated for oseltamivir stocks, seems that the drug is not enaugh useless for now.

Maybe that's not the case - and than the situation is worst, what remained than to the population without safe and matched vaccines, and without ventilators, and antivirals - a prayer only?

I'm not advocate any corpy, or vacc/med trial, and I'm sure that nobody liked ingesting harmfull drugs, but what are the options - to be triaged?<!-- / message --><!-- sig -->

The global pandemics are a problem for the entire society, not only for the single person. Thus, there is the need of a whole-society preparedness and public opinion pressure on local governments to ensure adeguate planning and medicines stockpiles. It is not possible to put in front at a pandemic with the force of one; the society at a whole must confronts with it, using the instruments of solidarity and equitable access to resources. Exactly at this joint doens't happen. The rich and the poor... and old story... I strong think that an advocacy in favor of OTC antimicrobials is a danger for the societies' security.

 

[tropical]

Re: Australia: Call for script-free Tamiflu drug sales

The global pandemics are a problem for the entire society, not only for the single person. Thus, there is the need of a whole-society preparedness and public opinion pressure on local governments to ensure adeguate planning and medicines stockpiles. It is not possible to put in front at a pandemic with the force of one; the society at a whole must confronts with it, using the instruments of solidarity and equitable access to resources. Exactly at this joint doens't happen. The rich and the poor... and old story... I strong think that an advocacy in favor of OTC antimicrobials is a danger for the societies' security.

Well said Ironorehopper, I agreed (all but the last sentence), but the world is not so soft.

Many people have not access to modern treatments, nor modern medicines.
Even with money, in many countries they have not the legal possibility to privately buy some new generation life-support medicines if the source country do not import it.
In an pandemic event that situation can only raise in worst.

Laws to get treated (pandemic, or not) with modern medicines, are rights we must achieve for all, not only a minority.

The danger for the society security is not because of releasing necessary meds, but because there are no willings to producing more meds, or enforcing and employing more med personnel and equipment before an dangerous event appeared.

Finaly, no matter about this debate, the button rooms are not at FT, and the situation will evolve in the same way like it was every time prior (historicaly) ...